Ralph has a history of alcohol abuse and has acute pancreatitis. Which lab value is most likely to be elevated?
A. Calcium
B. Glucose
C. Magnesium
D. Potassium
Correct Answer: B. Glucose
Glucose level increases and diabetes mellitus may result d/t the pancreatic damage to the islets of Langerhans. Acute pancreatitis is associated with damage to both the endocrine and exocrine pancreas. Glucose intolerance seen with this disease appears to be the result of hyperglucagonemia and relative hypoinsulinemia.
Option A: Initial evaluation of suspected acute pancreatitis involves laboratory abnormalities suggesting biliary cholestasis, hypercalcemia or severe hyperlipidemia will help in determining the etiology of pancreatitis. An abdominal ultrasound is recommended in all the patients to assess for choledocholithiasis and bile duct dilatation.
Option C: The diagnosis of acute pancreatitis has been defined by the Revised Atlanta Classification and requires at least 2 of 3 criteria be met: 1) a lipase or amylase level that is three times the upper limit of normal 2) abdominal pain that is consistent with pancreatitis 3) abdominal imaging consistent with acute pancreatitis.
Option D: A thorough history regarding alcohol use and medications should be gathered, keeping in mind that over five years of heavy alcohol use is often needed to induce alcohol-related pancreatitis. Smoking history is also important as a risk factor for acute pancreatitis.
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